Manifolding order-blank.



H. P. BROWN.

MANIFOLDING ORDER BLANK. APPLICATION FILED SEPT. I6. 1913.

1,21 1,81 9. Patented Jan. 9, 1917.

WITNESSES:

INVENTOR ED STATES PATENT OFFICE.

HORACE P. 3 BROWN, OF OAKLAND, CALIFORNIA, ASSIGNOR TO PACIFIC BURT CO., OF EMERYVILLE, CALIFORNIA, A CORPORATION OF ONTARIO, CANADA.

MANIFOLDING ORDER-BLANK.

- Specification of Letters Patent.

Patented Jan. 9, 1917.

To all whom it may concern:

Be it known that I, HORACE P. BROWN, a citizen of the United States, residing at Oakland, in the county of Alameda and State of California, have invented new and useful Improvements in Manifolding Order- Blanks, of which the following is a specification.

This invention relates to multigraph order blanks, particularly designed for use in the dining car service, restaurants, and elsewhere where it is desired to provide one or more unalterable copies of the original order for the purpose of preventing or lessening fraud.

The invention consists essentially of a sealed envelop constituting an order blank and the interior of which contains a carbonized surface with means whereby one or more'unalterable copies of the original writing on the face of the envelop will be provided.

Having reference to the drawings, Figure 1 is a face View of the obverse side of the blank. Fig. 2 is a view of the inside of the sheet. Fig. 3 is a perspective view of the obverse side of the envelop. Fig. a is a perspective view of the reverse side of the envelop. Fig. 5 is a perspective view of the obverse side of the blank showing the insert sheet. Fig. 6 is an inverted diagrammatic view showing the relative positions of the sheet.

In carrying out the invention I take a blank, as shown in Fig. 1, consisting of a front or face panel 2 and a back panel 3. The surface of the front panel 2, which will eventually be inside the envelop, is carbonized. The outside face of the panel 2 is suitably ruled as an order blank, and constitutes the original. The back panel 3 is adapted to be folded over the carbonized surface of panel 2. The three edge flaps 4: which are attached to panel 2 are then pasted down on the back panel 3. This is the invention in its simplest form as a d11- plicate order blank; the writing on the original being transferred as a positive carbon on the inside of the back panel 3. The blank thus filled in goes to the proper official, the envelop opened and the copies distributed as desired. If more than one carbon positive is desired I insert a sheet 5 into the envelop before sealing it, one side of which sheet 5 is carbonized with a carbon lying against the back 3. The result is that when the original is written on the carbonized back of the face panel produces a positive carbon copy on the uncarbonized side of the sheet 5, while the carbonized side of sheet 5 produces a second positive carbon on the uncarbonized back panel 3. Thus I produce three positive records of a transaction and two negatives formed on the carbonized surfaces which give additional protection.

Having thus described my invention what I claim and desire to secure by Letters Patent is A multigraph order blank comprising a sealed envelop structure consisting of a single sheet of paper folded at one side of its central line to form an upper writing sheet and a lower triplicate sheet wherein the upper sheet extends beyond the edge of the lower sheet to form a flap, flaps on the opposite and one adjacent edge of said sheet, a carbon backing on the inner face of said upper sheet and on two of said flaps, a loose sheet inserted between said upper and lower sheets to receive an imprint from said upper sheet, a carbon backing on the loose sheet to produce a triplicate imprint on the inner face of said lower sheet, and means for securing said flaps to the lower sheet to seal the structure.

In testimony whereof I have hereunto set my hand in the presence of two subscribing witnesses.

HORACE P. BROWN. Witnesses WILLARD W. WHITE, ALLAN LA FORTUNE.

copies of this patent may be obtained for five cents each, by addressing the Commissioner of Patents, Washington, D. 0. 

